During my time as a pediatrician in my native Karachi, Pakistan, I frequently encountered infants born prematurely due to preeclampsia. These fragile newborns, often fitting within the palm of a hand, struggled to breathe. Sadly, we couldn’t always save them.
Pregnancy complications like preeclampsia remain a mystery. The precise root cause of preeclampsia is unknown, just as effective methods for preventing preterm birth generally are. This knowledge deficit contributes significantly to maternal and newborn mortality worldwide. Each day, the lives of over 700 women and 6,500 newborns are lost to complications during pregnancy and childbirth. These tragic outcomes are most prevalent in sub-Saharan Africa and South Asia, often stemming from overburdened healthcare systems, unequal access to care, extreme poverty, and inadequate infrastructure.
A profound gap in understanding exists across almost all women’s health issues. Menopause provides a striking example; the fact that women can experience prolonged periods of feeling unwell, sometimes extending for a decade, is so commonplace it’s rarely recognized by doctors and researchers as a significant problem. This situation stems less from the complexity of the science and more from a pervasive sense of indifference. The tendency to dismiss women’s physical experiences has shaped research priorities, leading to certain conditions being overlooked. When a health issue is considered unremarkable rather than unacceptable, developing solutions naturally falls lower on the list of priorities.
Excluding cancer, less than one percent of healthcare research and innovation is dedicated to women’s health conditions. Compounded by the lower representation of women in clinical trials, this lack of focus means a substantial number of fundamental questions about women’s health remain inadequately studied. We acknowledge that heart disease, the leading cause of death for women globally, presents differently in this demographic, yet the underlying reasons are not fully understood. While we understand drug absorption into the brain, the mechanisms by which they enter the female reproductive system remain largely unknown. This stands in contrast to men, where, for instance, considerable knowledge exists regarding the effects of medications like Viagra.
Glimmers of Hope Emerge
Though progress is slow, positive shifts are beginning to manifest. In recent years, I have observed promising signs. At various conferences and discussions dedicated to topics ranging from global health to healthcare innovation, serious dialogue is underway among influential individuals regarding the necessity of investing in women’s health. I’ve witnessed decision-makers and investors acknowledge not only the vast scale of the problem but also the significant potential returns from addressing it after decades of neglect.
However, acknowledging the issue is only the first step. It is imperative that we allocate the necessary resources and attention to tackle the full breadth and complexity of challenges confronting women’s health as swiftly as possible.
Unlocking the Potential of Advanced Research
What truly excites me is the immense potential offered by advanced research, emerging tools, and innovative products. A compelling area for potential research is the vaginal microbiome, which refers to the diverse community of bacteria, both beneficial and potentially harmful, residing in the vagina. Global scientific inquiry into this area began in earnest only about a decade ago.
Currently, my team at the Gates Foundation is supporting investigations into how the vaginal microbiome influences pregnancy outcomes, including preterm birth, as well as women’s susceptibility to HIV and other sexually transmitted infections. While we are still in the early stages of discovery, the outlines of groundbreaking innovations that could benefit millions of women are becoming apparent.
For instance, interventions designed to promote and sustain the dominance of beneficial bacteria in the vagina could serve as a preventative measure against STIs. Such interventions could also address bacterial vaginosis, a common infection that, while mild on its own, can lead to serious complications during pregnancy, such as preterm birth. Furthermore, it can increase the risk factor for conditions like pelvic inflammatory disease and postpartum endometriosis, which can result in chronic pain and even infertility.
A Call for Partnership and Investment
Last year, the Gates Foundation committed $2.5 billion to women’s health innovation; however, this figure remains insufficient. Collaborative efforts are needed from partners across both public and private sectors globally. For the United Kingdom, this moment presents an opportunity to take a leading role, building upon its established strength in health innovation. Such leadership would not only help improve the lives of people domestically and internationally but also bolster one of its most dynamic and economically significant industries.
Investing in women’s health is, fundamentally, an investment in their lives and their ability to thrive. Women cannot achieve their full potential if their health is compromised. When women are healthy, they tend to be more creative in their professional lives, more engaged with their families, and more active participants in society. This principle holds true universally. In observance of International Women’s Day, let us translate this principle into reality by persistently reminding those in positions of power that women’s health is critically important, and that the time for dedicated resource allocation is now.
Anita Zaidi is president of gender equality at the Gates Foundation.